Individual
MR. THOMAS T BLAKE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
4715 SUNSET BLVD STE C, LEXINGTON, SC 29072-9151
(803) 520-8631
(803) 520-8634
Mailing address
4715 SUNSET BLVD STE C, LEXINGTON, SC 29072-9151
(803) 520-8631
(803) 520-8634
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3261
SC
111N00000X
Chiropractor
DC20126
CA
Other
Enumeration date
09/28/2006
Last updated
10/19/2011
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